CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Chelsea Hospital
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $181
- Cash Discount Price: $177
- vs. Medicare Baseline: 0.81x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Chelsea Hospital is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.81x the Medicare baseline. Located in 775 S Main St, Chelsea, MI.
Cash / Self-Pay
$177
Average discount available for prompt cash payment at this facility.
Insurance Median
$181
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$223.72
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $223.72 (100%)
Cash / Self-Pay: $177 (79%)
Insurance Median: $181 (81%)
Cash: $177 (79% of Medicare)
Ins. Median: $181 (81% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $223.72 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Input your details and click calculate to compare out-of-pocket costs.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $16 - $215 | 7% |
| U Of M Health Plan | $16 | 7% |
| Bcn Domestic | $26 | 12% |
| Blue Benefit Administrators Of Massachusetts | $26 | 12% |
| Blue Care Network | $26 | 12% |
| Blue Distinction Transplant | $26 | 12% |
| Blue Shield - Ca | $26 | 12% |
| Blue Shield - Id (Regence) | $26 | 12% |
| Blue Shield - Ny Highmark Northeastern | $26 | 12% |
| Blue Shield - Ny Highmark Western | $26 | 12% |
| Blue Shield - Pa (Highmark) | $26 | 12% |
| Blue Shield - Wa (Regence) | $26 | 12% |
| Health Choices | $26 - $181 | 12% |
| Kaiser Domestic | $26 | 12% |
| Asr Health Benefits | $47 | 21% |
| Caresource | $47 | 21% |
| Hap | $47 - $211 | 21% |
| Varipro | $47 | 21% |
| Wc Accident Fund | $72 | 32% |
| Wc Advantage | $72 | 32% |
| Wc Aig | $72 | 32% |
| Wc Allied | $72 | 32% |
| Wc Amerisure | $72 | 32% |
| Wc Amtrust | $72 | 32% |
| Wc Asu Risk Mgt | $72 | 32% |
| Wc Berkley Admin | $72 | 32% |
| Wc Broadspire | $72 | 32% |
| Wc Bunch & Associates | $72 | 32% |
| Wc Ccmsi | $72 | 32% |
| Wc Emc Insurance Company | $72 | 32% |
| Wc Esis | $72 | 32% |
| Wc Fcci | $72 | 32% |
| Wc Federated | $72 | 32% |
| Wc Gallagher Bassett | $72 | 32% |
| Wc Genex Care For Ohio | $72 | 32% |
| Wc Guard Insurance Company | $72 | 32% |
| Wc Hartford | $72 | 32% |
| Wc Liberty Mutual | $72 | 32% |
| Wc Meijers | $72 | 32% |
| Wc Michigan | $72 | 32% |
| Wc Mitchell Frankenmuth | $72 | 32% |
| Wc Pma | $72 | 32% |
| Wc Sedgwick | $72 | 32% |
| Wc Sentry | $72 | 32% |
| Wc Travelers | $72 | 32% |
| Wc Tristar | $72 | 32% |
| Wc Walmart | $72 | 32% |
| Wc Zurich | $72 | 32% |
| Medicaid / KanCare | $122 - $125 | 55% |
| Aetna | $127 - $215 | 57% |
| Geha | $150 - $183 | 67% |
| Meritain | $150 | 67% |
| Access Health | $181 | 81% |
| Acclaim | $181 | 81% |
| Administrative Concepts | $181 | 81% |
| Allegeant | $181 | 81% |
| Ameriben | $181 | 81% |
| American Family | $181 | 81% |
| American Healthcare Alliance | $181 | 81% |
| American National | $181 | 81% |
| American Republic | $181 | 81% |
| Amerihealth | $181 | 81% |
| Aultcare | $181 | 81% |
| Automated Benefit Services | $181 | 81% |
| Auxiant | $181 | 81% |
| Benefit Administrative Systems,Llc | $181 | 81% |
| Boon Chapman | $181 | 81% |
| Cam Administrative Services | $181 | 81% |
| Christian Brother Services | $181 | 81% |
| Christian Brothers Holy Cross | $181 | 81% |
| Comprehensive Benefits | $181 | 81% |
| Continental Life Insurance | $181 | 81% |
| Custom Benefit Administrators | $181 | 81% |
| Employee Benefit Concepts | $181 | 81% |
| Employee Benefit Management | $181 | 81% |
| Enterprise Group Planning | $181 | 81% |
| Freedom Life Insurance Company | $181 | 81% |
| Group Administrators | $181 | 81% |
| Group Marketing Services | $181 | 81% |
| Guardian | $181 | 81% |
| Health America | $181 | 81% |
| Healthcare Management Admin | $181 | 81% |
| Healthez | $181 | 81% |
| Humana | $181 | 81% |
| Insight | $181 | 81% |
| Intercare | $181 | 81% |
| Jfp Benefit Management | $181 | 81% |
| Jp Farley Corporation | $181 | 81% |
| Key Benefit Administrator | $181 | 81% |
| Liberty Union Life Assurance Co | $181 | 81% |
| Lucent Health | $181 | 81% |
| Luminare Health | $181 | 81% |
| Luminare Health (Detroit) | $181 | 81% |
| Magnacare | $181 | 81% |
| Medben | $181 | 81% |
| Medcost | $181 | 81% |
| Medical Mutual | $181 | 81% |
| Mutual Health Services | $181 | 81% |
| Mutual Of Omaha | $181 | 81% |
| Ncas | $181 | 81% |
| Nippon Life Ins | $181 | 81% |
| Nova | $181 | 81% |
| Painters Union Insurance Fund | $181 | 81% |
| Physicians Mutual | $181 | 81% |
| Plumbers Local 98 Insurance Fund | $181 | 81% |
| Prairie States | $181 | 81% |
| Preferred One | $181 | 81% |
| Primary Physician Care | $181 | 81% |
| Professional Benefit Administrators | $181 | 81% |
| Siho Insurance Services | $181 | 81% |
| Sisco Benefits | $181 | 81% |
| The Loomis Company | $181 | 81% |
| Unicare | $181 | 81% |
| Us Health And Life | $181 | 81% |
| Valenz | $181 | 81% |
| Western & Southern Financial Group | $181 | 81% |
| Wps | $181 | 81% |
| UnitedHealthcare | $183 - $226 | 82% |
| Coventry | $186 | 83% |
| First Health | $186 | 83% |
| Priority Health | $189 - $210 | 84% |
| Hospice Of Michigan | $190 | 85% |
| Cigna | $192 | 86% |
| 1199 National Benefit Fund | $204 | 91% |
| Allied National Global Care | $204 | 91% |
| Asrm - Reliance Standard Life Insurance | $204 | 91% |
| Christian Care Ministry | $204 | 91% |
| Dean Health | $204 | 91% |
| Fallon Health | $204 | 91% |
| Family Life Insurance Company | $204 | 91% |
| Ghc Scw | $204 | 91% |
| Group Pension Administrators | $204 | 91% |
| International Benefit Administrators | $204 | 91% |
| Lifetime Benefit Solutions | $204 | 91% |
| Manhattan Life | $204 | 91% |
| Medi Share | $204 | 91% |
| Multiplan | $204 | 91% |
| Mvp | $204 | 91% |
| Pai | $204 | 91% |
| Pan-American Life | $204 | 91% |
| Paramount Hmo | $204 | 91% |
| Phcs | $204 | 91% |
| Trinity Health Share | $204 | 91% |
| Health Partners | $211 | 94% |
| Tufts Health Plan | $211 | 94% |
| Blue Care Network Advantage | $215 | 96% |
| Medicare (plans) | $215 - $219 | 96% |
| Prime Health Services | $218 | 97% |
| Align Senior Care | $219 | 98% |
| Angela Hospice | $219 | 98% |
| Arbor Hospice | $219 | 98% |
| Heartland Hospice | $219 | 98% |
| Cca - Zing Health | $232 | 104% |
| Three Rivers Provider Network | $245 | 110% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $247 | 110% |
| Cmh Detroit Wayne Integrated Health Network | $272 | 122% |
| Cmh Jackson County/Lifeways | $272 | 122% |
| Cmh Lenawee County | $272 | 122% |
| Cmh Livingston County | $272 | 122% |
| Cmh Misc | $272 | 122% |
| Cmh Monroe County | $272 | 122% |
| Cmh Washtenaw County | $272 | 122% |
| Magellan Behavioral Health | $272 | 122% |
| Molina Marketplace | $285 | 127% |
| Health Cost Solutions | $339 | 152% |
| Vitalcore | $339 | 152% |
| Wellpath | $339 | 152% |
| Employee Benefit Logistic | $493 | 220% |